Polycystic ovary syndrome and type 2 diabetes mellitus: A state-of-the-art review

Abstract

Polycystic ovary syndrome (PCOS) often coexists with a wide spectrum of dysglycemic conditions, ranging from impaired glucose tolerance to type 2 diabetes mellitus (T2D), which occur to a greater extent compared to healthy body mass index-matched women. This concurrence of disorders is mainly attributed to common pathogenetic pathways linking the two entities, such as insulin resistance. However, due to methodological flaws in the available studies and the multifaceted nature of the syndrome, there has been substantial controversy as to the exact association between T2D and PCOS which has not yet been elucidated. The aim of this review is to present the best available evidence regarding the epidemiology of dysglycemia in PCOS, the unique pathophysiological mechanisms underlying the progression of dysglycemia, the most appropriate methods for assessing glycemic status and the risk factors for T2D development in this population, as well as T2D risk after transition to menopause. Proposals for application of a holistic approach to enable optimal management of T2D risk in PCOS are also provided. Specifically, adoption of a healthy lifestyle with adherence to improved dietary patterns, such the Mediterranean diet, avoidance of consumption of endocrine-disrupting foods and beverages, regular exercise, and the effect of certain medications, such as metformin and glucagon-like peptide 1 receptor agonists, are discussed. Furthermore, the maintenance of a healthy weight is highlighted as a key factor in achievement of a significant reduction of T2D risk in women with PCOS.

Therapy of obesity in women with PCOS using GLP-1 analogues — benefits and limitations [Terapia otyłości u kobiet z PCOS przy zastosowaniu analogów GLP-1 — korzyści i ograniczenia]

“…The exact pathophysiology of PCOS has not yet been fully explained [3]. Although there is a need to conduct further studies for a better understanding of all molecular mechanisms, it is accepted that both hyperandrogenism and insulin resistance are key factors in the development and sustaining metabolic and hormonal disturbances linked to PCOS [8]. It should be mentioned that the above-mentioned malfunctions are interconnected, and their effects are overlapping.…”

“…Another important pathogenic factor underlying PCOS is disrupted activity of the HPG axis. This axis is largely affected by hyperandrogenism and IR [8].…”

“…Dotychczas w pełni nie wyjaśniono patofizjologii PCOS [3]. Chociaż konieczne są dalsze badania w celu lepszego zrozumienia wszystkich mechanizmów molekularnych, przyjmuje się, że najważniejszymi czynnikami w rozwoju i utrzymywaniu się zaburzeń metabolicznych i hormonalnych związanych z PCOS są hiperandrogenizm i insulinooporność [8]. Należy wspomnieć, że powyższe zaburzenia są ze sobą powiązane, a ich skutki nakładają się na siebie.…”

“…Innym ważnym czynnikiem patogennym w rozwoju PCOS jest zaburzenie czynności osi HPG. Duży wpływ na działanie tej osi mają hiperandrogenizm i insulinooporność [8].…”

What’s Diet Got to Do With It? Basic and Clinical Science Behind Diet and Acne

“…This should be considered in patients with clinical features suggesting metabolic derangement such as acanthosis nigricans; elevated nonfasting triglycerides; or symptoms of polycystic ovarian syndrome, which include irregular menstruation, hirsutism, and early-onset androgenetic alopecia (also an independent sign of insulin resistance in men). [48][49][50][51]…”